替米沙坦对肥胖高血压患者胰岛素抵抗和血清视黄醇结合蛋白4水平的影响

目的: 观察替米沙坦对伴超重或肥胖的高血压患者血压、糖脂代谢指标和血清视黄醇结合蛋白4（RBP4）水平的影响。方法: 将45例门诊超重或肥胖的原发性高血压患者随机分为替米沙坦组(n=23)和氯沙坦组(n=22)，分别给予替米沙坦80 mg(qd)或氯沙坦100 mg(qd)，必要时加用长效钙拮抗剂，治疗16周。观察用药前后腰围、腰臀比、体质量指数、血压、空腹血糖、胰岛素、血脂和血清RBP4含量的变化。采用稳态模式法计算胰岛素抵抗指数（HOMA-IR）。结果: 两组治疗后，收缩压及舒张压与治疗前比较均明显下降，替米沙坦组分别降低20.5 mmHg和14.8mmHg，氯沙坦组分别降低18.3 mmH和14.2 mmHg，下降幅度组间比较无差异；替米沙坦组HOMA-IR和血清RBP4的含量明显下降，分别由7.24±1.82下降至6.02±2.16（P<0.05）和(46.9±15.0)mg/L下降至(39.8±14.8)mg/L（P<0.05）。结论: 替米沙坦可改善肥胖伴高血压患者的胰岛素敏感性、降低血清RBP4的水平。

Effects of telmisartan on insulin resistance and serum retinol-binding protein 4 in patients with essential hypertension

AIM: To investigate the effects of telmisartan on insulin resistance and serum retinol-binding protein 4 in patients with essential hypertension.METHODS: Forty-five subjects with essential hypertension were treated with telmisartan(80 mg/day) or losartan(100 mg/day) combined with long-acting calcium antagonist,if necessary,for 16 weeks.Waist and hip circumference,body mass index,blood pressure,fasting plasma glucose(FPG),insulin(FPI),lipid and retinol-binding protein 4(RBP4) were measured before and after t...